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Latar belakang. Hipotiroid kongenital merupakan gangguan hormon yang terjadi pada bayi baru lahir dimana ditemukan kadar hormon tiroid yang rendah. Pada bayi kurang bulan dan berat lahir rendah dapat mengalami hipotiroksinemia tanpa disertai peningkatan thyroid stimulating hormone. Hal ini bersifat sementara dan akan meningkat seiring pertambahan usia. Tujuan. Menilai perbedaan perubahan kadar hormon tiroid pada bayi kurang bulan melalui pemeriksaan fungsi tiroid serial serta faktor risiko yang berhubungan dengan hal tersebut. Metode. Kohort prospektif dengan melakukan pemeriksaan TSH dan FT4 serial pada BKB di NICU dan HCU Neonatus RSUD Dr. Moewardi bulan Oktober 2022 hingga Januari 2023. Pengambilan sampel dilakukan pada BKB dengan usia kehamilan < 32 minggu dan 32 s/d

Latar belakang. Penyakit jantung bawaan (PJB) sianotik merupakan kelainan jantung yang telah didapatkan sejak lahir, manivestasi dapat bervariasi dari ringan hingga berat. Anak dengan PJB membutuhkan perawatan paliatif disamping mendapatkan penanganan medis dari tenaga medis profesional. Perawatan Paliatif tersebut perlu adanya suatu pengembangan, sehingga perawatan paliatif diharapkan mampu meningkatakan kualitas hidup anak dengan PJB sianotik. Tujuan. Mengetahui pengaruh perawatan paliatif terhadap peningkatan kualitas hidup pada pasien anak dengan PJB sianotik. Metode. Pasien anak penderita PJB sianotik usia 2 hingga kurang dari 18 tahun yang berobat di bagian kardiologi anak RSUD Dr. Moewardi. Penelitian ini menggunakan desain penelitian uji acak terkontrol. Subjek penelitian dibagi menjadi 2 grup dengan cara matching dan dimasukkan ke dalam grup kontrol dan intervensi yang dilakukan perlakuan perawatan paliatif selama 3 bulan, kemudian dilakukan penilaian kualitas hidup subjek sebelum dan sesudah perlakuan tersebut menggunakan kuisioner PedsQL kardiologi. Hasil. Sejumlah 40 subjek diikutkan dalam penelitian, dibagi menjadi 20 subjek dalam kelompok intervensi dan 20 subjek dalam kelompok kontrol. Kelompok usia 2-4 tahun sebanyak 11 pasien kelompok intervensi didapatkan penurunan hasil nilai PedsQL dari mean 73,9 menjadi 63,2 yang menunjukkan adanya peningkatan kualitas hidup dengan hasil uji statistik pair t test p

Introduction Reducing neonatal deaths in premature infants in low- and middle-income countries is key to reducing global neonatal mortality. International neonatal networks, along with patient registries of premature infants, have contributed to improving the quality of neonatal care; however, the involvement of low-to-middle-income countries was limited. This project aims to form an international collaboration among neonatal networks in Asia (AsianNeo), including low-, middle- and high-income countries (or regions). Specifically, it aims to determine outcomes in sick newborn infants, especially very low birth weight (VLBW) infants or very preterm infants, with a view to improving the quality of care for such infants.Methods and analysis Currently, AsianNeo comprises nine neonatal networks from Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan and Thailand. AsianNeo will undertake the following four studies: (1) institutional questionnaire surveys investigating neonatal intensive care unit resources and the clinical management of sick newborn infants, with a focus on VLBW infants (nine countries/regions); (2) a retrospective cohort study to describe and compare the outcomes of VLBW infants among Asian countries and regions (four countries/regions); (3) a prospective cohort study to develop the AsianNeo registry of VLBW infants (six countries/regions); and (4) implementation and evaluation of educational and quality improvement projects in AsianNeo countries and regions (nine countries/regions).Ethics and dissemination The study protocol was approved by the Research Ethics Board of the National Center for Child Health and Development, Tokyo, Japan (reference number 2020–244, 2022–156). The study findings will be disseminated through educational programmes, quality improvement activities, conference presentations and medical journal publications.

Latar belakang. Selama beberapa dekade terakhir, angka kelahiran kurang meningkat di seluruh dunia. Bayi baru lahir, terutama Bayi Kurang Bulan sangat rentan terhadap stres oksidatif karena ketidakseimbangan antara peningkatan produksi Reactive Oxygen Species dan kurangnya kemampuan antioksidan. Adanya cedera oksidatif dapat dilacak dengan pengukuran penanda, malondialdehid hasil dari peroksidasi lipid. Tujuan. Untuk menilai hubungan kadar malondialdehid dengan usia kehamilan, berat lahir, dan asfiksia pada Bayi Kurang Bulan Metode. Penelitian cross-sectional dilakukan pada Bayi Kurang Bulan (Usia Kehamilan 28 - < 37 minggu) yang lahir di Rumah Sakit Umum Daerah Dr. Moewardi pada bulan Mei - November 2021. Teknik pengambilan sampel dilakukan secara consecutive. Variabel bebas adalah kadar malondialdehid, variabel terikat adalah Usia Kehamilan, Berat Lahir, dan asfiksia. Data dianalisis secara statistik dengan uji Kolmogorov-Smirnov, dan nilai p

Background Down syndrome (DS) is a chromosomal disorder due to trisomy 21 that may involve congenital heart disease (CHD). Pulmonary hypertension (PH) may be present in DS with and without CHD. TNF-α is a cytokine involved in the pathogenesis of inflammation in PH. Objective To determine the association between TNF-α and the risk of PH in children with DS with and without congenital heart disease. Methods This observational study was conducted in DS children aged two months to five years who visited the outpatient clinic of a regional referral hospital in Indonesia. Subjects underwent echocardiography and were classified into four groups (CHD-PH, CHD-no PH, no CHD-PH, no CHD-no PH). Serum TNF-α was measured in all subjects. We used the ANOVA test to compare mean TNF-α between the groups and to determine the optimal TNF-α cut-off point. We compared the risk of PH in subjects with TNF-α above and below the cut-off point. Results We included 36 DS children in this study. Mean TNF-α in the CHD-PH, CHD-no PH, no CHD-PH, and no CHD-no PH groups was 2,564.44 (SD 177.00) pg/mL, 2,112.89 (SD 382.00) pg/mL, 2,211.56 (SD 330.70) pg/mL, and 1,118.89 (SD 1056.65) pg/mL, respectively (p

Background The incidence of retinopathy of prematurity (ROP) is higher in Indonesia than in high-income countries. In order to reduce the incidence of the disease, a protocol on preventing, screening and treating ROP was published in Indonesia in 2010. To assist the practical implementation of the protocol, meetings were held in all Indonesia regions, calling attention to the high incidence of ROP and the methods to reduce it. In addition, national health insurance was introduced in 2014, making ROP screening and treatment accessible to more infants.Objective To evaluate whether the introduction of both the guideline drawing attention to the high incidence of ROP and national health insurance may have influenced the incidence of the disease in Indonesia.Setting Data were collected from 34 hospitals with different levels of care: national referral centres, university-based hospitals, and public and private hospitals.Methods A survey was administered with questions on admission numbers, mortality rates, ROP incidence, and its stages for 2016–2017 in relation to gestational age and birth weight.Results We identified 12 115 eligible infants with a gestational age of less than 34 weeks. Mortality was 24% and any stage ROP 6.7%. The mortality in infants aged less than 28 weeks was 67%, the incidence of all-stage ROP 18% and severe ROP 4%. In the group aged 28–32 weeks, the mortality was 24%, all-stage ROP 7% and severe ROP 4%–5%. Both mortality and the incidence of ROP were highest in university-based hospitals.Conclusions In the 2016–2017 period, the infant mortality rate before 32 weeks of age was higher in Indonesia than in high-income countries, but the incidence of ROP was comparable. This incidence is likely an underestimation due to the high mortality rate. The ROP incidence in 2016–2017 is lower than in surveys conducted before 2015. This decline is likely due to a higher practitioner awareness about ROP and national health insurance implementation in Indonesia.

Background Identification of gestational age, especially within 48 hours of birth, is crucial for newborns, as the earlier preterm status is detected, the earlier the child can receive optimal management. Newborn foot length is an anthropometric measurement which is easy to perform, inexpensive, and potentially efficient for predicting gestational age. Objective To analyze the diagnostic value of newborn foot length in predicting gestational age. Methods This diagnostic study was performed between October 2016 and February 2017 in the High Care Unit of Neonates at Dr. Moewardi General Hospital, Surakarta. A total of 152 newborns were consecutively selected and underwent right foot length measurements before 96 hours of age. The correlation between newborn foot length to classify as full term and gestational age was analyzed with Spearman’s correlation test because of non-normal data distribution. The cut-off point of newborn foot length was calculated by receiver operating characteristic (ROC) curve and diagnostic values of newborn foot length were analyzed by 2 x 2 table with SPSS 21.0 software. Results There were no significant differences between male and female newborns in terms of gestational age, birth weight, choronological age, and newborn foot length (P>0.05). Newborn foot length and gestational age had a significant correlation (r=0.53; P=0.000). The optimal cut-off newborn foot length to predict full term status was 7.1 cm. Newborn foot length below 7.1 cm had sensitivity 75%, specificity 98%, positive predictive value 94.3%, negative predictive value 90.6%, positive likelihood ratio 40.5, negative likelihood ratio 0.25, and post-test probability 94.29%, to predict preterm status in newborns. Conclusion Newborn foot length can be used to predict gestational age, especially for the purpose of differentiating between preterm and full term newborns.

Latar belakang. Bayi kurang bulan rentan terhadap stres dingin sehingga berisiko terjadi hipotermi. Hal ini menjadikan faktor suhu ruangan sangat penting sebagai bagian dari manajemen suhu pada kelahiran bayi kurang bulan. Tujuan. Menganalisis perbedaan pengaruh antara pengaturan suhu ruang operasi 240-260C dan 200-220C terhadap suhu bayi kurang bulan berat lahir rendah. Metode. Uji klinis dengan randomisasi dilakukan pada bulan Oktober 2016–Januari 2017 di ruang operasi IGD RS Dr. Moewardi Surakarta. Enampuluh bayi diambil secara konsekutif dibagi dalam kelompok kontrol (suhu operasi 200-220C) dan kelompok perlakuan (suhu ruang operasi 240-260C). Distribusi data tidak normal sehingga dalam bentuk median dan dianalisis menggunakan chi square dan Mann-Whitney test dengan program SPSS 17.0. Hasil. Median suhu bayi baru lahir pada kelompok perlakuan (36,10C) berbeda signifikan (p

Background Although it is clear that childhood obesity has asso- ciation with many aspects included social aspect, the social matu- rity aspect on childhood obesity is scarcely found. Objective To examine the prevalence of social maturity and the possible associated factors among obese children. Methods A cross sectional study was conducted from January to February 2005. Twenty percent of elementary schools in every sub- district were randomly selected. All obese children from selected schools were recruited to the study after obtaining the informed consent. Criteria of obesity in children was based on BMI e”95 th percentile according to age and sex. Social maturity was measured using Vineland Social Maturity Scale, which consisted of 8 catego- ries, i.e., self-help general, self-help eating, self-help dressing, self- direction, occupation, communication, locomotion, and socializa- tion. Social maturity score was determined using age group. The total score was divided into two categories i.e. immature and ma- ture. Possible associated factors with the social maturity such as gender, maternal education less than 9 years, being held back a class, and parental guidance by step mother were analyzed using SPSS 10.0 for Windows. Results There were 158 obese children recruited in the study. The prevalence of social immaturity was 32.5%. The odds ratio (OR) for parental guidance by single parent or others was 2.32 (95%CI 1.01;5.31); OR for intelligence was 3.93 (95%CI 1.42;10.89); OR for male was 2.41 (95%CI 1.08;5.38) and OR for maternal educa- tion less than 9 years was 1.22 (95%CI 0.61;2.41). Multivariate regression, analysis showed significant association between gen- der (for male OR=2.44; 95%CI 1.06;5.58) and intelligence (OR=3.31; 95%CI 1.12;9.84) with social maturity. Conclusion The prevalence of social maturity in obese children is high. The factors associated with social maturity among obese chil- dren are the history of had ever been held back a class and male. Further investigation is needed to find out the understanding of specific influence of social maturity in the prevalence of obesity.

Background Neonatal mortality remains a major concern in developing countries. Identifying potential risk factors is important in order to decrease the neonatal mortality rate. In Moewardi Hospital, Surakarta, the risk factors for neonatal mortality have not been assessed. Objective To evaluate potential risk factors of n eonatal mortality. Methods We reviewed medical records of all neonates hospitalized in the neonatal intensive care unit (NICU) at Dr. Moewardi Hospital from January to December 2011. Analyzed variables were sex, birth weight, gestational age, maternal age, place of delivery, mode of delivery, and sepsis. Data were analyzed by Chi square and binary logistic regression with 95% confidence intervals (CI). Results Out of841 neonates, the mortality rate was 212 (25.2%). Univariate logistic regression revealed that the significant risk factors for neonatal mortality were preterm (OR 4.41 ; 95%CI 4.24 to 4.57; P=0.0001) , low bir th weight (OR 4.30; 95%CI 4.13 to 4.47; P=0.0001), sepsis (OR 2.99; 95%CI 2.81 to 3.17; P=0.0001), maternal age 2:35 years (OR 1.53; 95%CI 1.37 to 1.70), and non-spontaneous delivery (OR 1.67; 95%CI 1.50 to 1.84). Further multivariate regression analysis revealed that the significant risk factors were preterm (OR 2.2 7; 95%CI 2.05 to 2.48; P=0.0001), low birth weight (OR 2.49; 95%CI 2.27 to 2.71; P= 0.0001), and sepsis (OR 2.50; 95%CI 2.30 to 2.69; P= 0.0001). Conclusion The risk factors for neonatal mortality in the NICU are preterm, low birth weight, and sepsis.

Background Mortality of neonatal sepsis is still a significant problem. It might be affected by many factors. Objective The purpose of this study was to determine factors which affect mortality of neonatal sepsis at neonatal ward of Moewardi Hospital, Surakarta. Methods Data of neonatal sepsis was obtained from medical records at the neonatal ward of Moewardi Hospital from December 2004 to November 2005. We recorded data from 97 neonatal sepsis consisted of 46 male and 52 female babies. Statistical analysis had been performed using univariate Chi-square and multivariate multiple logistic regression analysis. Results Overall neonatal sepsis mortality was about 40%. There were no significant difference in factors associated with mortality of neonatal sepsis such as gender (OR=0.44; 95% CI 0.19;1.014), referral patients (OR=1.61; 95% CI 0.195;.014), and bacterial growth culture (OR=1.96; 95% CI 0.856;4.44), except for birth weight which affected mortality (OR=6.29; 95% CI 2.57;15.42). Conclusion Birth weight affects mortality of neonatal sepsis in Moewardi Hospital. Patients with positive bacterial growth culture has two times higher risk of death, however, it is not statistically significant.

Heat exchangers are often found in the chemical process industry, but of all types of heat exchangers, the Shell and Tube Heat Exchanger (STHE) is the most commonly used. The design of heat exchangers has also been done a lot because it can reduce production costs. Therefore, this study purpose to design a tube and shell type heat exchanger for applications in producing nano zeolite. The TEMA standard is used as a reference for data collection regarding equipment specifications and dimensions. The parameters are calculated using basic Microsoft Office applications. Shell and Tube type heat exchanger (one pass) with 43 pcs of tubes has been successfully designed. The effectiveness of the heat exchanger reaches 80.02% so it is hoped that this research can be used as a reference in designing a heat exchanger with a better design.